COVID taught us a lot for future pandemics
I put much of this short article in up just to make the point, “we had no basis for what we were doing. And wat we did promote was not a cure. It was preventive actions on droplets within six feet rather than a plan to limit exposure to an aerosol spread of Covid. The article make that point. And Ms. Greene makes a fool of herself.
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COVID taught us a lot for future pandemics. Attacking Fauci doesn’t make us safer.
by Dr. Ashish K. Jha Contributor
USA Today
by Dr. Ashish K. Jha
In the early days of a pandemic, what we don’t know about a disease usually far outstrips what we do know. That’s the nature of new diseases – by definition, we don’t know much about them.
And there are usually a set of predictable questions – How does the virus spread? How dangerous is it? How can people protect themselves? Before we have answers to those questions, scientific experts are asked for guidance on what should be done. Typically, experts turn to what they do know from other similar viruses.
That was the story of the nation’s early response to COVID-19. When we knew very little about how the virus spread, scientists at the Centers for Disease Control and Prevention turned to what we did know about the spread of another respiratory pathogen: influenza or the flu. The CDC’s assessment has been, for decades, the flu spreads primarily through droplets or little bits of spit released when we speak or cough. Most of those droplets, based on CDC’s assessments, fall to the ground within about 3 feet of the infected person and certainly by 6 feet. This gave rise to what became a much maligned 6-feet rule in the early days of the pandemic.
The idea that a 6-feet rule could reduce the spread of COVID-19 was back in the news recently when Dr. Anthony Fauci, former head of the National Institute of Allergy and Infectious Diseases and adviser to seven U.S. presidents, testified before the House Subcommittee on the Coronavirus Pandemic.
Fauci’s testimony shares new details: COVID guidelines caused millions to suffer. Now Fauci admits ‘there was no science behind it.’
The 6-feet rule was a reasonable initial response to COVID-19 by the CDC based on scientists’ understanding of how the flu spreads.
The 6-foot rule, explained in the CDC’s July 2020 “Social Distancing” information sheet, suggests social distancing should be practiced to protect the spread of infection through coughs, sneezes or other methods of transmitting droplets from an infected person’s mouth or nose.
Social distancing wasn’t invented by Fauci
Even the idea of social distancing wasn’t new. Under the Bush administration, planning in 2007 for future outbreaks, social distancing was identified as a key tool for use early in a pandemic while vaccines and treatments were being developed.
And while social distancing has come under fire, there is clear empirical evidence that early action on social distancing saved many, many lives.
Preventing the next COVID-19 pandemic: World desperately needs a pandemic agreement. Will we come together to save lives?
While it makes some sense to use flu as the model for transmission in the early days of the COVID-19 pandemic, the key is to update information and guidance as quickly as possible with new knowledge on the virus you face. In any fast moving pandemic, decisions must be based on the best information available and updated with new scientific studies as quickly as possible. Then that information must be communicated to the public in a transparent way about what we know, what we don’t know, how we plan to find out, and so forth.
It turned out that the droplet model of transmission for COVID was wrong (and it may even be wrong for the flu – but that’s another matter).
We learned COVID-19 largely spreads through aerosols – tiny particles that can linger in the air for long periods of time and can travel distances much greater than 6 feet. A person across a poorly ventilated room can still get infected. Maintaining physical distance still reduces your risk from aerosols, but it is insufficient to fully protect against the spread of infection. This is why guidance around masking and indoor air quality are important.
That dynamic nature of science – where you learn new things and pivot guidance based on that new knowledge – is where our country did less well. When we saw more than 50 people get infected with COVID-19 at a choir practice in Washington state in March 2020, it was the first strong signal that COVID-19 was being spread by aerosols. But many months later, CDC was still recommending 6-feet distancing despite growing evidence that it was likely not enough.
And the CDC recommendations of 6-feet distancing made it much harder to reopen schools and businesses, which had its own substantial costs.
In these recent hearings, members of Congress unfairly attacked Dr. Fauci for the failures of the CDC and the Trump administration during the COVID-19 pandemic. Dr. Fauci was internally pushing for better data, but as the director of the National Institute of Allergies and Infectious Diseases, he could not openly contradict either the CDC or the administration.
There is no question that a switch to a new model of thinking about spread, that focused less on 6 feet and more on masking and clean air, would have been better at saving lives and allowing schools and businesses to reopen safely.
Does spread as an aerosol somehow preclude spread by droplet? From what I’ve read, isn’t “aerosol” on the droplet spectrum, just in sizes small enough that minimal air circulation currents can suspend for a long time? I have friends that think because the N95 mesh is still much larger than the individual virus, they probably don’t work. I think the case is more that viruses are trapped in the same saliva/mucus matrix as you find in droplets, but small ones, but very much larger than the virus alone. But not sure.
ERic:
Good question for Joel.
@Eric,
From what I’ve read, a fitted N95 mask provides a substantial barrier to aerosolized SARS-CoV-2. Unfitted masks, N95 or cloth, only protect others from virus if you’re coughing on sneezing. They don’t really protect you.
The utility of cloth masks is:
1. virtue signaling, to remind others to social distance;
2. keep you from touching your nose and mouth, two routes of infection;
3. prevent others from being infected by you if you’re coughing or sneezing.
I can’t believe they’re still bickering over this. Racist [*] dragging the the lab leak theory out again. My bet is if it leaked from a lab it was in Cincinnati, St Petersburg or Tel Aviv. With reporting that the trumpers ran a vax COINTEL on China, I’m wondering if the shadow government is (still) running one on us
Did you see where New York’s elected governor is proposing banning masks on the subway? Funny how New York keeps electing “Democrats” who turn out Republican
I said at the start I didn’t think this is the one that gets us all, now I’m not so sure
We go through about a box a month …
@Ten,
The *proposed* mask ban on NY subways concerns concealed identity, not anti-vaxxer sentiment.
That said, I’ve seen zero evidence of criminal behavior that was facilitated by an N95 mask. Happy to be educated, though.
If one were seriously concerned with N95 masks being used to conceal identity, the ban should apply to outdoors, where N95 masks make little or no difference to viral transmission, unlike enclosed spaces like subways (or bars, or churches, or chamber music performances, or Broadway theaters).
Our bank asks anyone who is masked to remove the mask and look at the camera before heading to the teller line. There are still a handful wearing masks.
My take on masks is that they were originally designed to eliminate breathing dust. In the absence of dust it takes a long time to reduce the mask’s effectiveness. I rotate through my masks and reuse them after a couple of weeks.
Swedes did not suddenly and drastically change course. For decades the World Health Organization had planned for a pandemic, and lockdowns of entire societies were never part of the discussion. Instead, plans focused on protecting the most vulnerable but trying to keep society as a whole up and running. What set Sweden apart was that it stuck to that plan, and from a Swedish perspective, it looked like it was the rest of the world that was engaging in a risky, unprecedented experiment.8
@Jackson,
Sweden is not like the US and the US is not like Sweden. The notion that there existed a best-fit paradigm for the COVID-19 pandemic response is hopelessly naive. Different cultures need different responses.
Mike the Mad Biologist rebuts New York Times horse-hocky …
@Ten,
Sadly, the NYT has become another right-wing mouthpiece. Or rather, continues to be, since they were also a cheerleader for the Bush Administration fake news about Iraq WMDs.
At this point, it is fair to say that the data on lab leak vs wet market are not dispositive, but the null hypothesis ought to be natural origin. The evidence that SARS-CoV-2 was engineered by humans is non-existent.
There is no evidence to support this, but from day zero my gut feeling has been the outbreak started due to someone selling research animals from the lab to the wet market. People are always going to take a quick buck (or, in this case, renminbi) wherever they can, even at the risk of starting a pandemic.
EYup ~ a reich-wing newsletter, with recipes …